Abstract
Many people find it challenging to self-manage complex and comorbid conditions. Others may have challenges remaining independent in their “home” because of cognitive or physical debility. Health and care providers often only become aware of a decline in an individual’s condition once symptoms have become severe enough to require escalation to primary or secondary care₁ . This scenario may be avoided by using technology.
Health and care providers internationally are increasing their investment in digital health solutions in their effort to meet each component of the Quadruple Aim₂ . By its nature, technology enabled care (TEC) offers a solution that aligns with the Quadruple Aim namely enhancing patient experience, improving population health, reducing costs and improving the work life of health care providers.
However, application of technology within complex organisational systems, such as health and care, involves various cycles of iteration, as technological, cultural and organisational dimensions gradually align (or not) over time. Co-creation is a suitable approach for developing and implementing TEC and transforming our services ensuring these dimensions are considered. This presentation aims to consolidate the learning from TEC implementation regionally, highlighting the critical factors that have previously demonstrated success, alongside the barriers to implementation. It will focus on a service design discovery process involving key stakeholders across the Northern Ireland health and social care system, illustrating how Discovery can leverage the familiar challenges that might prevent or enable improvements in a number of experimental areas.
Participants in this project include, service users, health and care professionals, policy makers, employees of non-departmental public bodies, care home managers, carers, housing association officers, charity and voluntary sectors. Participants will have differing levels of seniority, from directors with responsibilities for delivering regional policies and those with responsibilities for the management and direction of their own institutions, to those managing and delivering care every day. A number of service design workshops in each of the experiment areas will be conducted asking “How might we … ?” questions to ascertain participants’ thinking about the role that TEC may play and what factors/issues need to be addressed in order for it to be implemented.
Successful implementation of TEC as part of the delivery of person-centred, integrated health and care services is a complex and time-consuming process as the technology results in care providers having to radically transform practices at the point of care. It is envisaged that the output of this discovery work will inform the co-creation of a TEC framework, associated tools and capabilities for Northern Ireland contributing in significant ways to improving personalised care, helping people to optimise their independence and wellbeing in their own home and provide more cost-effective approaches.
₁ Hernandez C, Jansa M, Vidal M, et al. The burden of chronic disorders on hospital admissions prompts the need for new modalities of care: a cross-sectional analysis in a tertiary hospital. QJM 2009;102:193–202
₂ Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood). 2008 May-Jun;27(3):759-69. doi: 10.1377/hlthaff.27.3.759. PMID: 18474969.